Demodex infestation and density changes remain one of the main challenges in some clinical settings. Tumour necrosis factor-α (TNF-α) inhibitors have been recommended as a first-line treatment for ankylosing spondylitis (AS). However, there have been no studies investigating the impact of TNF-α inhibitor adalimumab on changes in the Demodex density in patients with AS. The aim of this study was to investigate Demodex density changes before and after adalimumab treatment and analyse the relationship between the Demodex density and clinical characteristics in AS. It was found that the Demodex density was positively correlated with age and C-reactive protein levels and the number of Demodex mites could increase after adalimumab treatment in AS.

The sequences of four mitochondrial genes were determined for Demodex mites isolated from two distantly related species within the family Cervidae, and identified morphologically as belonging to the species Demodex kutzeri. The sequences were used to test the hypothesis that Demodex are strictly host-specific, and hence cospeciate with their hosts: (1) The estimated divergence time between mites found on elk vs humans agreed closely with a previous estimate of the time that these host species last shared a common ancestor, suggesting cospeciation of mites and hosts, at least over long evolutionary timescales. (2) The extremely low levels of sequence divergence between the mites found on elk vs mule deer hosts indicated that these mites belong to the same species, which suggests that Demodex are able to move across host species boundaries over shorter timescales. Together, the results are consistent with the model that Demodex mites are not strict host-specialists, but instead lose the ability to move between host lineages gradually.